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If
you were having symptoms of heart disease – if you needed a diagnosis, or
treatment in the form of medication, or surgery – you would of course turn
to a clinician, a cardiac specialist. However, if you wanted advice on how to
live with heart disease – what to expect, how to handle side effects, whom
to tell, and how – you would want the advice and counsel of a person who
had lived with heart disease.
The impact of mental illness is no less
global. In fact, given that people with heart disease are not viewed with suspicion
and hostility merely for the fact of having heart disease, given that there are
no other diagnoses for which laws are passed requiring that patients follow doctors
orders, the ramifications of mental illness encompass a great deal more than the
illness itself.
The divide between those who treat mental illness and
those treated for mental illness is virtually complete. Owing to stigma and discrimination
at all levels of society, it is highly unusual to hear of anyone on the clinical
side who is also willing to disclose a history of mental illness. Then again,
there is tremendous disincentive for airline pilots, executives, police officers
and any other professional to disclose the same thing. Most of the time a person
is publicly identified as having a mental illness after he’s committed a
crime, done violence to himself or otherwise disrupted the community.
Living with mental illness is more about living than mental illness. The peer
movement is predicated on the idea that there is a knowledge base of proven, experiential,
indigenous wisdom that has come from struggling with the problems of mental illness
in concrete ways. Services at CHOICE are designed, managed, supervised and provided
by people who have experienced mental illness, diagnosis, hospitalization and
homelessness, as well as the discrimination and stigma attached to them. We are
in a significant sense the peers of the people who come to us for help.
People who come to CHOICE seeking help, understanding and support know they will
get it. The agency acts as an open, inviting door to the mental health system
in Westchester County because we have a reputation for treating our clients with
respect, empathy and acceptance.
The agency as a whole serves as an example
to the community of what people with mental illness can accomplish.
When we speak of "peers" we mean more than simply having been diagnosed
and treated for a mental illness.
The
Peer Accreditation Association defines a Peer as someone who has been affected
by:
 A
psychiatric label and prejudice associated with it.
Determination
by other (e.g. relatives, service providers) to lack competency and negative valuation
as a result of diagnosis.
Discrimination
from family, friends, treatment providers and society in general.
Major
life disruptions such as homelessness, repeated unemployment, extended isolation,
loss of important relationships, childhood and adult trauma, loss of civil liberty
through institutionalization or other forms of confinement.
Major,
protracted experiences such as disabling fear, anxiety, depression, hopelessness,
helplessness, stemming from having a diagnostic label or from traumatic life events
and inhumane mental health treatment.
Significant
positive altered states associated with energy, creativity, spirituality, and
other like phenomena.
Questions have been raised about the use of the term "labeled" when
discussing diagnoses. One author stated "[There] is no reference to people
labeled with physical disabilities. That is because physical disabilities can
be seen; it is hard, after all, for any observer to dispute the reality of a wheelchair."
There are conclusive tests for physical illnesses and disabilities.
Blood tests will show conclusively that someone has diabetes, or a staph infection.
X-rays will show conclusively whether a bone is broken. There are no such conclusive
tests to show whether someone has schizophrenia, or schizoaffective disorder,
or bipolar disorder.
This is not to deny the existence of these disorders.
But people are often misdiagnosed; they can suffer the extreme side effects of
medications that weren’t right for them in the first place, and often clinicians
make a diagnosis based on how the person reacts to the medication and not vice
versa. There is also the practice of referring to people as their diagnosis: schizophrenics,
for example, or, more broadly, mental patients. That’s only a half step away
from epithets like lunatic, head case, and so on.
In truth, diagnoses
are labels: they are often applied without solid scientific evidence, merely clinical
opinion. At CHOICE we often provide services to people who have rejected treatment
based on past negative treatment experiences; by recognizing and acknowledging
this, we are able to gain their trust, and ultimately create a productive partnership.
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